Canadian Journal of Nursing Informatics


This article was written on 21 Dec 2022, and is filled under Volume 17 2022, Volume 17 No 3-4.

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Nursing Innovation and Open Source License

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Nurse Developer Column

By Raymund John Ang, RN, MAN, PhD St

Raymund is currently a PhD student at the Holy Angel University (Philippines), and works as a clinical analyst in Pennsylvania, USA. He is the project lead of the Open Nursing Information System (Open-NIS) Project
Nursing Innovation and Open Source License

Citation: Ang, R. J. (2022). Nursing Innovation and Open Source License. Nurse Developer Column. Canadian Journal of Nursing Informatics, 17(3-4).

For technologically inclined nurses, the realm of application development has been made more attainable through no-code and low-code platforms, and open-source applications and packages. Although understanding of basic coding or programming is still vital, creating healthcare or nursing applications are within reach for nurse innovators – with a caveat that the developer must be familiar with legal, regulatory, security and privacy concerns.

Nurse developers who are planning on integrating open-source software into their infrastructure should audit packages to install, such as when using package management. Package management systems provide ease in searching for and downloading software application modules or packages, and their dependencies (Blum & Bresnahan, 2021). This is particularly convenient and practical when managing software assets using the command line, and not having to download and install software packages individually and manually.

The Open Source Initiative or OSI ( is a valuable resource when it comes to open source licenses, and the open source software ecosystem in general. The OSI has a list of some of the widely known open-source licenses, such as MIT, BSD, Apache and GNU GPL ( Aside from the four freedoms of open source – freedom to run, study/modify, redistribute, and improve (Information Resources Management Association, 2015) – nurse developers must also be aware of salient differences in these licenses, and the obligations that they entail. Since the code for the software (and dependencies) is publicly available, there should be a process in place to check for vulnerabilities and possible exploits and must not rely solely on the altruism of the open-source community. Differences on how these open-source licenses are enforced could also mean the organization or startup that the developer is engaged in may need to reveal or distribute its own code modifications to users of their platform over a network, and not just through the act of distributing the modified application (Mehmood, See, Katib & Chlamtac, 2020).

Despite a seemingly easier and straightforward application development workflow through open source and package management, nurse innovators should also take into consideration the type of open-source licenses they are incorporating and be cognizant of the associated responsibilities and how these licenses are enforced.


Blum, R., & Bresnahan, C. (2021). Linux command line and shell scripting bible. John Wiley & Sons, Inc.

Information Resources Management Association (2015). Open source technology: Concepts, methodologies, tools, and applications. IGI Global.

Mehmood, R., See, S., Katib, I., & Chlamtac, I. (Eds.) (2020). Smart infrastructure and applications: Foundations for smarter cities and societies. Springer Nature Switzerland AG.

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